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Objective: To study the effects of cervical headgear treatment of Class II division 1 malocclusion on upper airway structures in children. Materials and Methods: Forty children aged 9.1 (7.2–11.5) years with Class II division 1 malocclusion were treated using a cervical headgear as the only treatment appliance. The headgear consisted of a long outer bow bent 15° upward and a large inner bow expanded 10 mm larger than the intermolar distance. Lateral cephalograms were taken before and after the treatment. Upper airway structures were estimated from the cephalograms. The results were compared to cross-sectional data of 80 age-matched controls with a Class I molar relationship. Results: A Class I molar relationship was achieved in all treated children. The mean treatment time was 1.6 (0.3–3.1) years. The Class II malocclusion was accompanied by a similar or wider nasopharyngeal space than in the controls but narrower oro- and hypopharyngeal spaces. The retropalatal area was widened by the treatment (P < .05), whereas the rest of the oropharynx and hypopharynx remained narrower than in the controls. Before the treatment, the mandibular plane was in a more horizontal position than in the controls, but during the treatment, it rotated to a position similar to that of the controls. Conclusion: Class II division 1 malocclusion is associated with a narrower upper airway structure even without retrognathia. Headgear treatment is associated with an increase in the retropalatal airway space.

To study the effects of cervical headgear treatment of Class II division 1 malocclusion on upper airway structures in children.Forty children aged 9.1 (7.2-11.5) years with Class II division 1 malocclusion were treated using a cervical headgear as the only treatment appliance. The headgear consisted of a long outer bow bent 15 degrees upward and a large inner bow expanded 10 mm larger than the intermolar distance. Lateral cephalograms were taken before and after the treatment. Upper airway structures were estimated from the cephalograms. The results were compared to cross-sectional data of 80 age-matched controls with a Class I molar relationship.A Class I molar relationship was achieved in all treated children. The mean treatment time was 1.6 (0.3-3.1) years. The Class II malocclusion was accompanied by a similar or wider nasopharyngeal space than in the controls but narrower oro- and hypopharyngeal spaces. The retropalatal area was widened by the treatment (P.05), whereas the rest of the oropharynx and hypopharynx remained narrower than in the controls. Before the treatment, the mandibular plane was in a more horizontal position than in the controls, but during the treatment, it rotated to a position similar to that of the controls.Class II division 1 malocclusion is associated with a narrower upper airway structure even without retrognathia. Headgear treatment is associated with an increase in the retropalatal airway space.

Class-II, division-1 malocclusion appears to be associated with a narrow maxilla. A Class-II malocclusion may be corrected to a Class-I relationship in children using a cervical headgear provided that the narrow maxilla is expanded. This expansion is possible using headgear by dental cast analysis, but this has not been confirmed by cephalometry. We studied the effects of orthopedic cervical headgear on dental and skeletal facial widths in 40 children aged 9.1 (7.2-11.5) who had Class-II, division-I malocclusions. The headgear consisted of a long outer bow bent 15 degrees upward and a large inner bow expanded by 10 mm. Posteroanterior cephalographs and dental casts were taken before and after treatment. The results were compared with the control values presented in the literature. The malocclusion was treated to a Class-I relationship in all children. The average treatment time was 1.6 (0.3-3.1) years. The maxilla was widened significantly (P.0001). The upper first molar width (um-um) and maxillary width (mx-mx) increased 3.2 and 1.6 mm/y, respectively. Maxillary widening was also observed in the nasal structure as indicated by an increase in lateronasal width (lap-lap) by 1.0 mm/y (P.005). With maxillary widening, the mandibular dental arch widened spontaneously. The lower first molar width (lm-lm) increased 0.8 mm/y, which was more than the increase in the controls (P.0001). However, the antegonial width (ag-ag) remained unaffected. By using a widened inner bow in headgear therapy with Class-II malocclusions, a widening of maxilla and nasal cavity may be obtained.